Robert Todd Bennett, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY-411 Issued in ID

Practice address

1755 Westgate Dr
Suite 260
Boise, ID 83704-7174

Phone

(208) 373-0790

Fax

(208) 373-0816

NPI assigned

Oct 10, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

University of Vermont College of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cornerstone Psychological Associates, PLLCGroup PAC ID 6103801683, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cornerstone Psychological Associates, PLLC

  • Clinical Psychologist
  • Boise, ID
  • NPI 1184766396
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304380800000",
    "number": "1962490474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 WESTGATE DR",
            "address_2": "SUITE 260",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837047174",
            "telephone_number": "208-373-0790",
            "fax_number": "208-373-0816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 WESTGATE DR",
            "address_2": "SUITE 260",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837047174",
            "telephone_number": "208-373-0790",
            "fax_number": "208-373-0816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "ROBERT",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2011-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ID",
            "license": "PSY-411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "00010031804",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "N5491",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley W Bennett, MD
• Jessica Bennett, CNM
• Kristen Ray Bennett, LCSW
• Matthew Scott Bennett, PHD
• Renee Rachelle Bennett, RN
• Sharon Bennett, MSN, SPRN, FNP-C
• Zachary Mark Bennett, BC-HIS
• Beverly Paige Bennion
• Christian Bennion, DMD
• Corryn N Bennion

• Clinical Psychologist in Boise, ID
• Providers in Boise, ID by specialty
• Clinical Psychologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.